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Organization
BROOKS SPEECH LANGUAGE THERAPY SERVICES
Active
Organization
BROOKS SPEECH LANGUAGE THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SYDNEY BROOKS MASON CCC-SLP (SPEECH/LANGUAGE PATHOLOGIST)
(321) 501-0282
Entity
Organization
Contact information
Practice address
1117 TAPP RD, VAN BUREN, AR 72956-6844
(321) 501-0282
Mailing address
1117 TAPP RD, VAN BUREN, AR 72956-6844
(321) 501-0282
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP 487
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116145721
—
AR
01
—
56203
BLUE CROSS BLUE SHIELD
AR
Enumeration date
09/24/2013
Last updated
09/24/2013
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